Brief Answer:
You are fine. Tendency to develop diabetes - preventable

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Trying to conceive can be a wonderful as well as a frustrating journey. I understand your anxiety and would like to tell you not to worry.
You will still be able to conceive with the right lifestyle and guidance.

Would you clarify a few things for me, please?
*why did you have the medical termination?when and at how many weeks?
*how long have you been married?
*how old is your husband?
*did you conceive naturally the first time?
*are your periods regular?
*any history of obesity, Infertility, diabetes, heart disease or hypertension in the family?
*how many hours after a meal did you check the insulin levels?

Your TSH level is within normal limits but while trying to conceive, it is better to have the level between 1-2.5.
*how much thyronorm are you taking now?

Insulin is needed for glucose to enter the cells, so that can use it for normal function.
When this is not happening, more insulin is produced as a feedback mechanism to improve the cellular uptake of glucose.
This can happen in overweight /obese individuals or in high stress, sedentary lifestyle and improper diet. The cell metabolism changes in a way that it doesn't respond normally to the insulin, thus increasing its produxtion
This situation doesn't mean that you have diabetes but it increases your chances of developing it in the future.

I recommend :
-daily, atleast 5 days a week of exercise.
Start with walking for a half hour a day. If time is hard to come by, do 3 rotations of 10minutes each. Exercise while you sit at work. take the stairs.
Walk to nearby areas/shops.

-eat healthy. Cut off refined grains and processed foods and stick with whole grain and homemade foods
Eat smaller but more frequent meals. This helps burn more energy efficiently and keeps your metabolism steady through the day.

-metformin can cause fluctuations in sugar levels to make sure to eat on time and do not skip meals. This makes you put on weight in the long run.

-switch to no fat or low fat milk. Keep sugar intake to 2 teaspoons a day.
-minimize caffeine to one cup a day

-take a daily folic acid supplement.

-monitoring your basal body temperature and using ovulation prediction kits will help detect your fertile period and ovulation day. This is when, if you have had regular Intercourse during this period, you have excellent chances of getting pregnant.

-monitor TSH after 4-6 weeks to check for need for dose adjustment and effectiveness.

-losing weight can help improve stress levels and fertility.

-Have regular intercourse (every alternate day) in the middle third of your cycle (between day 10-20 in a 30day cycle, for instance).

Nothing is wrong with you now. Just some imbalances noted. All you need is to be cautious and not ignore your health.

If you do not conceive in a year with regular intercourse, consult a fertility specialist to see what's going on.

Hope this helps. Please let me know if there is anything else I can help you with.
Wish you good health,

Regards,
Dr. Shuba Hariprasad

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Brief Answer:
Welcome

Detailed Answer:
Hello,
Thank you for the follow up and clarifications.

*how are your periods now?

Do not focus too much on the weight. Just exercise and eat healthy. This itself will improve fertility. Initially you will notice an increase in weight and then a gradual decrease.

Focus instead on completing your quota of exercise per day & eating a balanced diet.

I am sure you will conceive soon. I hope I've helped. Please let me know if there is anything else I can help you with.
Wish you good health.

Regards,
Dr. Shuba Hariprasad

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